<include file="header" />
<div class="wraper" js="wapjs/base/print/js/confirm">
	<div class="head clearfix">
		<a href="javascript:history.go(-1);" class="iconfont icon-zuo pull-left"></a>
		<span class="head-name pull-left">绑定</span>
		<a href="javascript:history.go(-1);" class="pull-left text-right"></a>
	</div>
		<div>
			<input type="hidden" name="conf_id" value="{BEESCRM:$conf_id}" />
			<div class="container">
				<div class="form-list clearfix"><span class="field pull-left">工号</span><input name="receiver_sn" class="pull-right" value="{BEESCRM:$staffInfo.number}" placeholder="请输入您的工号" readonly="readonly" /></div>
				<div class="form-list clearfix"><span class="field pull-left">姓名</span><input name="receiver_name" class="pull-right" value="{BEESCRM:$staffInfo.real_name}" placeholder="请输入您的真实姓名" readonly="readonly" /></div>
				<div class="form-list clearfix"><span class="field pull-left">联系方式</span><input name="receiver_tel" class="pull-right" value="{BEESCRM:$staffInfo.mobile}" placeholder="请输入您的手机号" size="11" maxlength="11" /></div>
			</div>
			<div class="container">
				<div class="form-list clearfix">
					<span class="field pull-left">角色</span>
					<select name="role_id" class="pull-right" id="role-select">
						<option value="0">请选择您的角色</option>
						<foreach name="printRole" item="vo" key="key">
							<option value="{BEESCRM:$key}">{BEESCRM:$vo}</option>
						</foreach>
					</select>
					<span class="iconfont icon-wodedingdan18"></span>
				</div>
			</div>
			<!-- 如果选择的角色是设计和技术 则下面可用 否则不可用 -->
			<div class="container adminName">
				<div class="form-list clearfix">
					<span class="field pull-left">PC账号</span>
					<select name="receiver_admin_name" class="pull-right" id="adminName">
						<option value="">请选择后台登录账号</option>
					</select>
					<span class="iconfont icon-wodedingdan18"></span>
					<span class="cover"></span>
				</div>
			</div>
		</div>
		<div class="btn-box">
			<a href="javascript:void(0)" class="btn bg-green confirm_submit">确认提交</a>
			<input type="hidden" name="conf_id" value="{BEESCRM:$conf_id}" />
		</div>
	</form>
	<div class="layerwraper"></div>
</div>
<div class="layer-wraper auth">
	<div class="main">
		<p class="title">提交成功</p>
		<p class="text-12">身份信息已提交，请等待审核！</p>
		<!--
		<div class="pop-btn">
			<a href="javascript:void(0)" class="btn cancel">取消</a>
			<a href="javascript:void(0)" class="btn green-btn error-submit">确定</a>
		</div>

		-->
	</div>
</div>
<include file="footer" />